Association of Aortic Stiffness and Cognitive Decline: A Systematic Review and Meta-Analysis

Background: Increased aortic stiffness has been found to be associated with cognitive function decline, but the evidence is still under debate. It is of great significance to elucidate the evidence in this debate to help make primary prevention decisions to slow cognitive decline in our routine clinical practice.Methods: Electronic databases of PubMed, EMBASE, and Cochrane Library were systematically searched to identify peer-reviewed articles published in English from January 1, 1986, to March 16, 2020, that reported the association between aortic stiffness and cognitive function. Studies that reported the association between aortic pulse wave velocity (PWV) and cognitive function, cognitive impairment, and dementia were included in the analysis.Results: Thirty-nine studies were included in the qualitative analysis, and 29 studies were included in the quantitative analysis. The aortic PWV was inversely associated with memory and processing speed in the cross-sectional analysis. In the longitudinal analysis, the high category of aortic PWV was 44% increased risk of cognitive impairment (OR 1.44; 95% CI 1.24–1.85) compared with low PWV, and the risk of cognitive impairment increased 3.9% (OR 1.039; 95% CI 1.005–1.073) per 1 m/s increase in aortic PWV. Besides, meta-regression analysis showed that age significantly increased the association between high aortic PWV and cognitive impairment risk.Conclusion: Aortic stiffness measured by aortic PWV was inversely associated with memory and processing speed and could be an independent predictor for cognitive impairment, especially for older individuals.

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Association of Circulating Cholesterol Level with Cognitive Function and Mild Cognitive Impairment in the Elderly: A Community-based Population Study

Current Alzheimer Research ◽

10.2174/1567205017666200810165758 ◽

2020 ◽

Vol 17 (6) ◽

pp. 556-565

Author(s):

Yujie Guo ◽

Pengfei Li ◽

Xiaojun Ma ◽

Xiaochen Huang ◽

Zhuoheng Liu ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Cholesterol Level ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Cross Sectional ◽

Increased Risk ◽

Aging Adults ◽

Female Subjects

Background: The present study was designed to examine the association of circulating cholesterol with cognitive function in non-demented community aging adults. Methods: This was a cross-sectional study including 1754 Chinese adults aged 55-80 years. The association between serum cholesterol levels and cognitive function was examined. Participants were categorized into four groups according to the quartile of circulating TC (total cholesterol), High Density Lipoprotein Cholesterol (HDL-c), Low Density Lipoprotein Cholesterol (LDL-c) levels and HDLc/ LDL-c ratio. The difference in cognitive performance among the groups was compared. Logistic regression model was used to determine the association of circulating cholesterol level with the risk of Mild Cognitive Impairment (MCI). Results: Mild increase of serum LDL-c level correlated with better visual and executive, language, memory and delayed recall abilities. Higher circulating TC and HDL-c levels were found to be associated with poorer cognitive function, especially in aging female subjects. Higher circulating TC, HDL-c and HDL/LDL ratio indicated an increased risk of MCI, especially in female subjects. Conclusion: Slight increase in circulating LDL-c level might benefit cognitive function in aging adults. However, higher circulating TC and HDL-c levels might indicate a decline of cognitive function, especially in aging female subjects.

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Cognitive function and risk for depression in old age: a meta-analysis of published literature

International Psychogeriatrics ◽

10.1017/s1041610210000049 ◽

2010 ◽

Vol 23 (4) ◽

pp. 516-525 ◽

Cited By ~ 34

Author(s):

Chang-Quan Huang ◽

Zheng-Rong Wang ◽

Yong-Hong Li ◽

Yi-Zhou Xie ◽

Qing-Xiu Liu

Keyword(s):

Cognitive Impairment ◽

Relative Risk ◽

Cognitive Function ◽

Longitudinal Studies ◽

Old Age ◽

Meta Analysis ◽

Incidence Rates ◽

Cochrane Library ◽

Cross Sectional ◽

Risk For Depression

ABSTRACTBackground: We assessed the relationship between cognitive impairment (including mild cognitive impairment with no signs of dementia, and dementia) and risk for depression in old age (60 years and older).Methods: MEDLINE, EMBASE and the Cochrane Library database were used to identify potential studies. All of the clinical studies that produced data on the association between cognitive function and risk of depression among individuals aged 55 years or older were identified and included in this review. The studies were classified into cross-sectional and longitudinal subsets. The quantitative meta-analysis of cross-sectional and longitudinal studies were performed. For prevalence and incidence rates of depression, odds risk (OR) and relative risk (RR) were calculated, respectively.Results: Since all but two studies found in the search were for individuals aged 60 years or over, we assessed and reported on results for this larger group only. In this review we included 13 cross-sectional and four prospective longitudinal studies. The quantitative meta-analysis showed that, in old age, individuals with non-dementia cognitive impairment had neither significant higher prevalence nor incidence rates of depression than those without (odds risk (OR): 1.48, 95% confidence intervals (95% CI): 0.87–2.52; relative risk (RR): 1.12, 95% CI: 0.62–2.01). In old age, individuals with dementia had both significant higher prevalence and incidence rates of depression than those without (OR: 1.82, 95% CI: 1.15–2.89; RR: 3.92, 95% CI: 1.93–7.99).Conclusions: Despite the methodological limitations of this meta-analysis, we found that in old age, there was no association between depression and cognitive impairment with no dementia; however, there was a definite association between depression and dementia and thus dementia might be a risk for depression.

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Subjective Memory Complaints and Mild Cognitive Impairment

European Psychiatry ◽

10.1016/s0924-9338(09)71326-4 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1 ◽

Cited By ~ 2

Author(s):

M. Simoes ◽

L.C. Castro ◽

O. Ribeiro ◽

T. Salgado ◽

C. Paz

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

The Elderly ◽

Future Research ◽

Older Individuals ◽

Subjective Memory Complaints ◽

Subjective Memory ◽

Cross Sectional ◽

Memory Complaints ◽

Increased Risk

Background:Subjective Memory Complaints (SMC) are common in clinical practice. the clinical significance of these subjective complaints among older individuals is not well understood.Aim:To study and discuss the association between SMC and MCI, underlining the importance of an adequate clinical assessment of SMC in the elderly.Methods:Review of the literature.Results:There is no consistent definition of SMC in the literature. Some prospective studies showed an association with objective memory impairments, conceptualizing SMC as a Pre-Mild Cognitive Impairment. SMC are also currently considered to be a core feature of Mild Cognitive Impairment (MCI). Cross-sectional studies and longitudinal studies showed conflicting results concerning the association between SMC and MCI.Discussion:The understanding of the predictive value of SMC in cognitive decline is still poorly understood. It is important to define criteria aimed to increase specificity of memory complaints, allowing an earlier identification of populations with higher risk of MCI. Future research on this complex association is important to identify SMC individuals at increased risk of conversion to MCI and dementia.

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Informant-based hearing difficulties and the risk for mild cognitive impairment and dementia

Age and Ageing ◽

10.1093/ageing/afz099 ◽

2019 ◽

Vol 48 (6) ◽

pp. 888-894 ◽

Cited By ~ 1

Author(s):

Maria Vassilaki ◽

Jeremiah A Aakre ◽

David S Knopman ◽

Walter K Kremers ◽

Michelle M Mielke ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Daily Activities ◽

Cross Sectional ◽

Cox Proportional Hazards Models ◽

Increased Risk ◽

Hearing Difficulties

Abstract Background: hearing loss has been associated with mild cognitive impairment (MCI) and dementia. Studies have not assessed whether hearing difficulties (HD) that interfere with daily activities as reported by partners can be a marker for increased risk for cognitive decline and impairment. Objective: to assess the cross-sectional and longitudinal associations between informant-based HD, which interfere with daily activities and the risk for MCI and dementia. Methods: the study included 4812 participants without dementia, enrolled in the Mayo Clinic Study of Aging (mean age (SD) 73.7 (9.6) years) with cognitive evaluation and informant-based report on participant’s HD that interfere significantly with daily activities at baseline and for every 15 months. Cox proportional hazards models (utilising time-dependent HD status and age as the time scale) were used to examine HD and the risk for MCI or dementia, and mixed-effects models (allowing for random subject-specific intercepts and slopes) were used to examine the relationship between HD and cognitive decline. Results: about, 981 participants had HD and 612 (12.7%) had prevalent MCI at baseline; 759 participants developed incident MCI and 273 developed incident dementia. In cognitively unimpaired participants at baseline, those with HD had higher risk for MCI (hazard ratio [HR] = 1.29, 95% confidence interval [CI] (1.10, 1.51), P = 0.002; adjusting for sex, years of education). In participants without dementia, those with HD had higher risk for dementia (HR: 1.39, 95% CI, (1.08–1.79), P = 0.011; adjusting sex and education). In individuals with MCI, HD was associated with modestly greater cognitive decline. Conclusions: informant-based HD was associated with increased risk for MCI and dementia.

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Inflammatory Potential of Diet Is Associated with Biomarkers Levels of Inflammation and Cognitive Function among Postmenopausal Women

Nutrients ◽

10.3390/nu13072323 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2323

Author(s):

Aleksandra Skoczek-Rubińska ◽

Agata Muzsik-Kazimierska ◽

Agata Chmurzynska ◽

Małgorzata Jamka ◽

Jarosław Walkowiak ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Decline ◽

Postmenopausal Women ◽

Necrosis Factor Alpha ◽

Physically Active ◽

Inflammatory Index ◽

Increased Risk ◽

Anti Inflammatory ◽

Estrogen Depletion

In postmenopausal women (PW), estrogen depletion may predispose to cognitive decline through an increased risk of chronic inflammation. Unhealthy diets also appear to have an impact on the cognitive health of these women. The aim of this study was to investigate the association between inflammatory potential of the diet, levels of inflammatory biomarkers, and cognitive function in PW. In a population of 222 PW, energy intake-adjusted Dietary Inflammatory Index (E-DII) was used to assess the dietary inflammatory potential. Cognitive function was estimated using the Polish version of Mini-Mental State Examination (MMSE), corrected by age and educational level. Selected biochemical inflammatory markers (C-reactive protein, CRP; interleukin-6, IL-6; and tumor necrosis factor alpha, TNF-α) were measured by ELISA tests. PW with an anti-inflammatory diet (first tercile) had significantly higher MMSE, while BMI, percentage fat mass and TNFα concentration were significantly lower compared to those with the most proinflammatory diets (third tercile). Women with cognitive impairment had significantly higher IL-6 concentrations (4.1 (0.8) pg/mL vs. 2.5 (0.2) pg/mL, p = 0.004), and were less educated (12.7 (0.7) years vs. 14.1 (0.2) years, p = 0.03) and less physically active compared to cognitively normal women. PW with the most proinflammatory diets had increased odds of cognitive impairment compared to those with the most anti-inflammatory diets, even after adjustment (OR = 11.10, 95% confidence level; 95%CI: 2.22; 55.56; p = 0.002). Each one-point increase in E-DII (as a continuous value) was also associated with 1.55-times greater odds of cognitive impairment (95%Cl: 1.19; 2.02 p = 0.003) in this population. Dietary inflammation may increase the risk of cognitive impairment in PW, but future studies should include a more sensitive battery of tests to assess cognitive function in this population. Implementation of an anti-inflammatory dietary pattern in PW may help prevent cognitive decline.

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Cerebral Microbleeds are Associated with Impairments in Executive Function and Processing Speed

Journal of Alzheimer s Disease ◽

10.3233/jad-201202 ◽

2021 ◽

pp. 1-8

Author(s):

Xuanting Li ◽

Junliang Yuan ◽

Wei Qin ◽

Lei Yang ◽

Shuna Yang ◽

...

Keyword(s):

Cognitive Impairment ◽

Executive Function ◽

Cognitive Function ◽

Processing Speed ◽

Population Aging ◽

Brain Magnetic Resonance Imaging ◽

Executive Dysfunction ◽

Linear Regression Models ◽

Cross Sectional ◽

Global Cognitive Function

Background: Cerebral microbleed (CMB) is an increasingly important risk factor for cognitive impairment due to population aging. Controversies, however, remain regarding the exact association between CMB and cognitive dysfunction. Objective: We aimed to determine the relationship between CMB burden and cognitive impairment, and also explore the characteristics of cognitive decline in CMB patients for middle-aged and elderly people. Methods: The present cross-sectional study included 174 participants (87 CMB patients and 87 controls) who underwent brain magnetic resonance imaging and a battery of neuropsychological test. Global cognitive function was measured using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Compound z-scores were calculated for three cognitive subdomains: memory, executive function and processing speed. Results: CMB patients had lower scores of MMSE (p < 0.001) and MoCA (p < 0.001). Patients at each category of CMB count had worse performance in global cognitive function and all three cognitive subdomains (p < 0.001). In multiple linear regression models, CMB patients had significantly greater declines in executive function (p < 0.001), processing speed (p < 0.001), and MoCA (p = 0.003) with increasing number of CMB. We found no relationship between CMB location and cognition (p < 0.05). Conclusion: CMB is associated with impairment in global cognition as well as for all tested subdomains. Strongest effect sizes were seen for tests which rely on executive functioning, where performance deficits increased in proportion to degree of CMB burden. Prospective studies are needed to evaluate whether the association between CMB and executive dysfunction is causal.

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Protective Lifestyle Factors and Cognitive Function in a Middle- to Older-Aged Population: A Cross-Sectional Analysis

Proceedings of The Nutrition Society ◽

10.1017/s0029665120000221 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Laxmi Gautam ◽

Sean Millar ◽

Ivan J. Perry ◽

Janas Harrington

Keyword(s):

Logistic Regression ◽

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Decline ◽

Inverse Association ◽

Cross Sectional ◽

Cognitive Score ◽

Lifestyle Behaviours ◽

Cross Sectional Analysis ◽

Sectional Analysis

AbstractBackground and ObjectivesCognitive impairment among the elderly is an important concern worldwide. Evidence suggests that certain lifestyle behaviours may have a protective effect against cognitive decline. In this study we examined the relationship between a 5-component protective lifestyle behaviour score and cognitive function to determine whether the number of protective lifestyle behaviours is related to cognitive decline.Materials and MethodsThis was a cross-sectional analysis of the Mitchelstown Cohort Rescreen study, a random sample of men and women aged 51–77 years recruited from a single primary care centre. Cognitive function was assessed using the Mini Mental State Exam (MMSE) and cognitive data were available for 1,022 participants. Cognitive impairment was classified as an upper 75th percentile reversed MMSE score value for the study sample. We defined 5 low-risk protective lifestyle behaviours as never smoking, moderate alcohol intake, moderate to vigorous physical activity, a high-quality diet score (upper 40%) and a body mass index between 18.5 to 24.9 kg/m2. Linear and logistic regression analyses were used to test associations between a protective factor score and the MMSE.ResultsThere was a linear relationship between the number of protective lifestyle behaviours and mean cognitive score values and a significant inverse association was observed between a protective lifestyle score and the MMSE cognitive score (β = -0.20, 95% CI: -0.30, -0.10). Logistic regression suggested a dose-response relationship, with odds ratios of having poorer cognitive functioning being noticeably increased in subjects with 0 or 1 PLBs (OR = 2.18, 95% CI: 1.06, 4.52) when compared to participants with 4 or 5 PLBs in multivariable analysis.ConclusionsThese data imply that a combination of healthy lifestyle behaviours protects against cognitive impairment. As all of the examined factors are modifiable, small behavioural changes may help in preventing cognitive decline in an elderly population.

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Physical activity and depression in older adults with and without cognitive impairment

Dementia & Neuropsychologia ◽

10.1590/1980-57642018dn12-010002 ◽

2018 ◽

Vol 12 (1) ◽

pp. 12-18 ◽

Cited By ~ 7

Author(s):

Kornanong Yuenyongchaiwat ◽

Khajonsak Pongpanit ◽

Somrudee Hanmanop

Keyword(s):

Physical Activity ◽

Older Adults ◽

Cognitive Impairment ◽

Depressive Symptoms ◽

Geriatric Depression Scale ◽

Depression Scale ◽

The Elderly ◽

Older Individuals ◽

Cross Sectional ◽

Increased Risk

ABSTRACT Low physical activity and depression may be related to cognitive impairment in the elderly. Objetive: To determine depression and physical activity (PA) among older adults with and without cognitive impairment. Methods: 156 older adults, both males and females, aged ≥60 years, were asked to complete the Thai Mini-Mental State Examination (Thai-MMSE), a global cognitive impairment screening tool. Seventy-eight older adults with cognitive impairment and 78 older adults without cognitive impairment were then separately administered two questionnaires (i.e., the Thai Geriatric Depression Scale; TGDS and Global Physical Activity Questionnaire; GPAQ). Logistic regression analysis was used to determine the risk of developing cognitive impairment in the groups of older individuals with and without cognitive impairment. Results: A cross-sectional study of elderly with a mean age of 74.47 ± 8.14 years was conducted. There were significant differences on the depression scale and in PA between older adults with and without cognitive impairment. Further, participants with low PA and high level of depressive symptoms had an increased risk of cognitive impairment (Odds ratio = 4.808 and 3.298, respectively). Conclusion: Significant differences were noted in PA and on depression scales between older adults with and without cognitive impairment. Therefore, increased PA and decreased depressive symptoms (i.e., having psychological support) are suggested to reduce the risks of cognitive impairment in older adults.

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Testosterone and Cognitive Impairment or Dementia in Middle-Aged or Aging Males: Causation and Intervention, a Systematic Review and Meta-Analysis

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988720933351 ◽

2020 ◽

pp. 089198872093335 ◽

Cited By ~ 1

Author(s):

Zhichao Zhang ◽

Deying Kang ◽

Hongjun Li

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Verbal Memory ◽

Meta Analysis ◽

Free Testosterone ◽

Cochrane Library ◽

Total Testosterone ◽

Testosterone Levels ◽

Increased Risk ◽

Developmental Test

Background and Purpose: To investigate the association between testosterone levels and the risk of dementia and to assess the effectiveness of testosterone supplement treatment in patients with cognitive impairment or dementia. Methods: We searched Pubmed, Cochrane Library, and EMBASE on September 30, 2019. Results: The risk factor portion of the review included 27 studies with 18 599 participants. Studies revealed inconsistent findings on the association between testosterone levels and the risk of all-cause dementia or Alzheimer disease (AD). The result from our meta-analysis showed an increased risk of all-cause dementia with decreasing total testosterone (total-T, 4572 participants, hazard ratio: 1.14, 95% CI: 1.04-1.26). Some studies also found an increased risk of AD with a lower level of total-T, free testosterone, and bioavailable testosterone. Testosterone supplement treatment may improve general cognitive function and motor response in the short term as measured by the Developmental Test of Visual-Motor Integration (mean difference [MD]: 4.4, 95% CI: 1.20-7.59) and the Mini-Mental State Examination (MD: 3.4, 95% CI: 0.83-5.97) and verbal memory as measured by story recall delay at 3 months (MD: 8.4, 95% CI: 0.49-16.3). Conclusion: Lower levels of testosterone may be associated with an increased risk of all-cause dementia or AD. Testosterone supplement treatment may or may not improve general cognitive function in patients with cognitive impairment/AD.

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Vision impairment and cognitive decline among older adults: a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-047929 ◽

2022 ◽

Vol 12 (1) ◽

pp. e047929

Author(s):

Niranjani Nagarajan ◽

Lama Assi ◽

V Varadaraj ◽

Mina Motaghi ◽

Yi Sun ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Quality Assessment ◽

Assessment Tool ◽

Vision Impairment ◽

Cochrane Library ◽

Case Control Studies ◽

Cross Sectional

ObjectivesThere has been increasing epidemiological research examining the association between vision impairment (VI) and cognitive impairment and how poor vision may be a modifiable risk factor for cognitive decline. The objective of this systematic review is to synthesise the published literature on the association of VI with cognitive decline, cognitive impairment or dementia, to aid the development of interventions and guide public policies pertaining to the relationship between vision and cognition.MethodsA literature search was performed with Embase, Medline and Cochrane library databases from inception to March 2020, and included abstracts and articles published in peer-reviewed journals in English. Our inclusion criteria included publications that contained subjective/objective measures of vision and cognition, or a diagnosis of VI, cognitive impairment or dementia. Longitudinal or cross-sectional studies with ≥100 participants aged >50 years were included. The search identified 11 805 articles whose abstracts underwent screening by three teams of study authors. Data abstraction and quality assessment using the Effective Public Health Practice Project Quality Assessment Tool were performed by one author (NN). 10% of the articles underwent abstraction and appraisal by a second author (LA/VV), results were compared between both and were in agreement.Results110 full-text articles were selected for data extraction, of which 53 were cross-sectional, 43 longitudinal and 14 were case–control studies. The mean age of participants was 73.0 years (range 50–93.1). Ninety-one (83%) of these studies reported that VI was associated with cognitive impairment.ConclusionOur systematic review indicates that a majority of studies examining the vision–cognition relationship report that VI is associated with more cognitive decline, cognitive impairment or dementia among older adults. This synthesis supports the need for additional research to understand the mechanisms underlying the association between VI and cognitive impairment and to test interventions that mitigate the cognitive consequences of VI.

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